心臟手術(shù)輸血方式的探討
本文關(guān)鍵詞: 自體輸血 心臟手術(shù) 用血量 血型 年齡 性別 出處:《中國(guó)輸血雜志》2017年08期 論文類型:期刊論文
【摘要】:目的分析探討本院擇期心臟手術(shù)患者輸血方式及異體血輸注量差異,為今后的臨床工作提供一定的參考信息。方法搜集本院2016年1月1日-12月31日共計(jì)115例獲得明確臨床診斷的心臟手術(shù)患者的臨床輸血資料,分析其性別、年齡、血型、病種的分布情況,并對(duì)其輸血方式和各種異體成分血的輸注情況進(jìn)行回顧性的統(tǒng)計(jì)分析。結(jié)果 115例術(shù)中輸血的心臟手術(shù)患者中,81例患者應(yīng)用自體輸血,方式均為術(shù)中回收式,其中76例亦有異體血輸注,5例僅輸注自體血;34例術(shù)中僅輸注異體血。術(shù)中應(yīng)用自體輸血的患者年齡明顯高于無(wú)自體輸血者,有自體輸血者以冠狀動(dòng)脈硬化性心臟病(冠心病)和風(fēng)濕性心臟瓣膜病(風(fēng)心病)居多,其手術(shù)風(fēng)險(xiǎn)大,多是2種輸血方式并用,其中,冠心病手術(shù)患者男性明顯多于女性;術(shù)中沒(méi)有自體輸血的患者多是先天性心臟病(先心病)的兒童,其術(shù)中異體血的輸注量明顯低于老年心臟手術(shù)患者。各個(gè)血型間平均用血量無(wú)顯著差異,不同病種間各成分血平均用量可見(jiàn)顯著差異。結(jié)論心臟手術(shù)多數(shù)需要施行體外循環(huán),操作時(shí)間長(zhǎng),出血量多,因此用血量很大,應(yīng)根據(jù)病種做好術(shù)前備血工作,并積極開(kāi)展自體輸血等血液保護(hù)措施。
[Abstract]:Objective to analyze the difference of blood transfusion and allogeneic blood transfusion in patients undergoing elective cardiac surgery in our hospital. Methods from January 1st 2016 to December 31st, the clinical blood transfusion data of 115 patients undergoing cardiac surgery with definite clinical diagnosis were collected. The distribution of sex, age, blood type and disease was analyzed. The methods of transfusion and the blood transfusion of various allogeneic components were analyzed retrospectively. Results among 115 patients undergoing cardiac surgery, 81 patients were treated with autologous blood transfusion. Among them 76 cases also had allogeneic blood transfusion and 5 cases only infused autologous blood. Only allogeneic blood was infused in 34 cases. The age of the patients who received autologous blood transfusion during operation was significantly higher than that of the patients without autologous blood transfusion. Patients with autologous blood transfusion mainly had coronary sclerosing heart disease (coronary heart disease) and rheumatic heart valve disease (rheumatic heart disease). The number of male patients with coronary heart disease was significantly higher than that of women. The patients without autologous blood transfusion during operation were mostly children with congenital heart disease (CHD). The volume of allogeneic blood transfusion during operation was significantly lower than that in the elderly patients. There was no significant difference in the average blood consumption among different blood groups. Conclusion Cardiac surgery requires cardiopulmonary bypass (CPB), long operating time and much blood loss. Therefore, the blood volume should be very large, and the preoperative blood preparation should be done well according to the disease species. And actively carry out autotransfusion and other blood protection measures.
【作者單位】: 同濟(jì)大學(xué)附屬東方醫(yī)院南院檢驗(yàn)科;
【基金】:上海市東方醫(yī)院重點(diǎn)學(xué)科建設(shè)項(xiàng)目(YZX-2015-10-2)
【分類號(hào)】:R457.1;R654.2
【正文快照】: 輸血是臨床治療中不可或缺的重要手段之一,臨床輸血包括自體輸血和異體輸血2大類,我們通常所講的臨床輸血是指異體輸血。隨著社會(huì)和醫(yī)學(xué)領(lǐng)域?qū)Ξ愺w輸血存在潛在的疾病傳播的巨大風(fēng)險(xiǎn)的認(rèn)識(shí)不斷深入,以及血液資源嚴(yán)重短缺的局面又難以解決,自體輸血的作用和意義凸顯重要。自體
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